A MAN with deadly ‘camel flu’ that can be passed by coughing flouted doctors orders by boarding a plane a day later.
The patient, a Saudi Arabian man in his 50s, was admitted to hospital with a fever, cough and heart palpitations but discharged himself the next day “against medical advice” before travelling.
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Swabs taken during the man’s hospital stay revealed that his symptoms were caused by Middle East respiratory syndrome coronavirus (MERS-CoV) – a rare but severe respiratory illness.
But by that time, he’d already taken a flight to Pakistan – leaving health officials scrambling to locate him and trace people he came into contact with.
Symptoms of the virus – dubbed ‘camel flu’ due to being found in the animals – can start off as a fever and cough.
But these can spiral into pneumonia and severe breathing difficulties, which can prove deadly to some.
Read more on viral threats
According to the World Health Organisation (WHO), MERS is fatal to about 36 per cent of people who contract it – though it noted that this figure may be inflated due to mild cases of the illness being under-reported.
The virus is most often identified in people who’ve been in contact with infected animals and there’s evidence that camels in the Middle East are the main source of MERS.
But it can also be passed from person to person through virus-laden droplets that spray into the air when someone coughs.
In the case of the Saudi Arabian patient, it’s unclear how he contracted MERS as he hadn’t come into contact with camels, nor was he a health worker – another circumstance that can put people at risk of contracting the sometimes deadly disease.
The man, aged between 50 and 55 and living in an eastern region of the Kingdom of Saudi Arabia, developed a fever, cough, shortness of breath and palpitations on August 28 this year, according to a WHO report.
His symptoms were initially flagged as heart-related when he was admitted to a local hospital on August 31, but he was transferred to a medical complex on September 1.
“From there he was discharged at his request the same day, against medical advice,” the report said.
He proceeded to board a flight the following day, September 2.
Swabs testing for respiratory illnesses were taken during the man’s hospital stay.
They came back as positive for MERS-CoV on September 4 – by which time the man had already travelled to Pakistan.
Health officials were left scrambling to locate the man, with fears he may have spread the disease.
The NHS notes that MERS doesn’t seem to be very contagious between people unless they’re in close contact.
After being tracked down in Pakistan, the man was transferred to a public hospital and placed under “strict isolation”.
Health authorities in the Kingdom of Saudi Arabia monitored a member of the patient’s household, 23 health workers and two patients who came into contact with him.
His contacts in Pakistan were also followed up.
“A total of 41 nasopharyngeal samples, including repeat samples of the case and close contacts were collected and tested,” the WHO report stated.
“The patient tested positive, albeit with a low viral load, while all contacts tested negative.
“Close contacts, including family members and health workers, were closely monitored for 14 days, and no secondary cases have been identified.”
The patient was finally discharged on September 13 after receiving a negative test result for MERS-CoV.
A follow-up appointment five days later confirmed he’d made a full recovery from the dangerous virus.
Since the beginning of the year, a total of five cases of camel flu have been reported from the Kingdom of Saudi Arabia, along with four deaths.
A previous WHO disease outbreak alert issued in May flagged that three people who had no direct contact with camels had contracted MERS, sparking concerns of a wider spread.
Most previous outbreaks are traced back to people working in close contact with the animals or their raw milk.
PANDEMIC THREAT
MERS is a relatively new disease and was first identified in Saudi Arabia in 2012 when it jumped from camels to humans.
Since then, there have been 2,204 cases and 860 deaths, according to the WHO.
The majority of cases are reported in the Arabian Peninsula, but some have been discovered elsewhere – including the UK.
A total of five cases of MERS have been reported in the UK since 2012, with the most recent in August 2018.
The bug is part of the coronavirus family that can cause diseases ranging from the common cold to severe acute respiratory syndrome (SARS).
MERS is more deadly but less transmissible than its sister bug, Covid-19.
Explained: Middle East respiratory syndrome
Middle East respiratory syndrome (MERS) is a viral respiratory infection caused by MERS-CoV.
Humans can get MERS-CoV through either direct or indirect interaction with camels.
It does not pass easily between humans but can be caught through prolonged, unprotected contact with a sufferer.
Instances of human-to-human transmission have been observed among close contacts and within healthcare environments.
But outside of health care settings, there has been limited human-to-human transmission to date, WHO notes.
Symptoms range from mild cough and fever to severe respiratory failure and death.
The illness can start with:
- Fever
- Cough
- Difficulty breathing
- Diarrhoea and vomiting
In severe cases, the illness may result in respiratory failure and requires treatment in an intensive care unit.
There is no vaccine, although several are in development.
The WHO has previously listed MERS as one of several diseases —alongside the mysterious disease X, an as-yet unknown pathogen —that had the potential to spark an epidemic but for which there is no specific treatment or vaccine.
The NHS advises people travelling to the Middle East – especially those with long-term medical conditions – to practice good hygiene.
This means regularly washing your hands with soap and water, especially after visiting farms, barns or market areas.
You should also:
- Avoid contact with camels
- Avoid raw camel milk and/or camel products
- Avoid eating or drinking any type of raw milk, raw milk products, and any food that may be contaminated with animal secretions, unless it’s been peeled and cleaned and/or thoroughly cooked
According to WHO, the virus tends to cause more severe outcomes in older adults, people with weakened immune systems, and those with underlying health conditions such as renal disease, cancer, chronic lung disease, and diabetes.
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